Characteristics and causes of death in children with neonatal abstinence syndrome

© 2020 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: To determine characteristics of death in children with neonatal abstinence syndrome (NAS). Methods: A population-based linkage study of children from birth to 13 years of age in New South Wales (NSW), Australia, born 1 July 2000 to 31 December 2011. Infants with an International Statistical Classification of Diseases and Related Problems, Australian modification coding of NAS (P96.1, n = 3842) were compared to infants (n = 1 018 421) without NAS by birth, hospitalisation and death records linkage. Results: Forty-five (1.2%) children with NAS died, compared to 3665 (0.4%) other children. Most deaths (n = 30, 66%) in NAS children occurred between 1 month and 1 year. Risk of death was independently increased in full-term children (hazard ratio 2.34, 95% confidence interval 1.63–3.35; P \u3c 0.001) from lower socio-economic groups (1.23, 1.12–1.35; P \u3c 0.001), most commonly from ill-defined or external causes, including assault and accidents (P \u3c 0.001). Conclusions: Children with NAS, especially those of term gestation and from lower socio-economic groups, are more likely to die, especially from external causes